Susano B. Tanael Jr1
1 Section of Medical Oncology, Jose R. Reyes Memorial Medical Center, Sta Cruz, Manila
Corresponding author: Susano B. Tanael Jr; susano.tanael@gmail.com
Poetry reading and engagement have been explored as potential complementary approaches to support healing, well-being, and spiritual growth in cancer patients and other healthcare settings. This intersection of literature, psychology, spirituality, and medicine offers intriguing possibilities for holistic patient care and inspires and motivates further exploration.
Research on Poetry Intervention, Spirituality, and Healing in Cancer Care
Several studies have investigated the effects of poetry interventions on psychological, emotional, and spiritual outcomes in cancer patients. Tegnér et al.1 conducted a qualitative study examining how cancer patients experienced poetry reading sessions. They found that participants reported feeling a sense of connection, both to themselves and others, through engaging with poetry. Furthermore, the creation of meaning was described as relating the poetic themes to their life experiences, providing comfort and new perspectives on their illness journey. Participants also reported experiences of transcendence and connection to something greater than themselves, suggesting a spiritual dimension to their engagement with poetry.
In a randomized controlled trial, Bozcuk et al.2 investigated the effects of a poetry therapy intervention on anxiety and depression in cancer patients. The intervention group showed significant improvements in both measures compared to the control group, providing reassurance and optimism about the therapeutic benefits of engaging with poetry for psychological well-being.
Rickett et al.3 explored the use of poetry writing, rather than just reading, as a means of meaning-making for cancer patients. Their analysis revealed that the act of creating poetry allowed patients to express complex emotions, but more importantly, it enabled them to reframe their experiences, finding new sources of strength and resilience. This aspect of poetry can instill a sense of optimism and motivation in healthcare professionals and researchers about its potential impact on cancer patients.
Numerous studies have associated spiritual well-being with better health outcomes and quality of life.4 Poetry, with its ability to evoke emotions, convey complex ideas, and explore existential themes, has been identified as a potential medium not only for addressing spiritual needs but also for fostering profound spiritual growth.5 This potential for spiritual growth through poetry offers a hopeful and inspiring outlook for the future of cancer care.
In a study of hospice patients, Furman et al.6 explored using poetry as a spiritual intervention. They found that reading and discussing poetry allowed patients to reflect on their lives, express their fears and hopes, and find spiritual comfort. The researchers noted that poetry provided a unique and powerful language for articulating spiritual experiences that patients often struggled to express otherwise. This finding can enlighten healthcare professionals and researchers about the empathetic potential of poetry in cancer care.
Olson-McBride and Page7 investigated the use of poetry therapy in a group setting for individuals with mental illness. They observed that engaging with poetry often led to discussions of spiritual and existential themes, allowing participants to explore their beliefs and find meaning in their experiences. This spiritual engagement was associated with improved emotional well-being and personal growth.
A systematic review by Fancourt and Finn8 examined various arts-based interventions in healthcare settings, including poetry. They concluded that poetry interventions show promise for improving emotional expression, reducing anxiety and depression, and enhancing the overall quality of life in cancer patients. Additionally, they highlighted the potential of arts-based interventions, including poetry, in promoting spiritual well-being.
The process of creating meaning through poetry engagement has been linked to concepts in narrative medicine and expressive writing. Charon9 argues that engaging with and creating narratives, including poetic forms, can help patients make sense of their illness experiences and promote healing.
Carroll10 argued for integrating poetry into nursing practice to address patients’ spiritual needs. She suggested that healthcare professionals, particularly those in palliative care and psychosocial oncology, can play a crucial role in facilitating poetry interventions. By selecting and discussing poems that resonate with patients’ experiences, these professionals can help patients make sense of their illness experiences and promote healing.
While the existing literature suggests potential benefits in meaning-making and spiritual well-being, it is essential to note that more rigorous research is needed to fully establish the efficacy of poetry interventions in cancer care and other healthcare settings. Challenges such as patient preferences, cultural differences, and the need for trained facilitators may affect the implementation of poetry interventions. Future studies should focus on identifying poems for reading and expression that fit the needs of patients, evaluating these identified poems, and conducting long-term follow-ups to understand better poetry’s role in supporting healing, spiritual growth, and overall well-being for patients.
Multifaceted Approach in Choosing Poems for Patient Reading and Expression
The approach of using close reading, critical appraisal, and broader applicability analysis in poetry therapy for cancer patients represents an innovative integration of literary analysis and therapeutic practice. This method builds upon existing research while offering a more structured and comprehensive framework for poetry intervention.
Close poetry reading has been recognized as a valuable tool in therapeutic settings. Furman11 explored close-reading techniques in poetry therapy, noting that detailed analysis of literary devices and themes can help patients uncover deeper meanings and personal connections. In the context of cancer patients, this approach may facilitate a more profound engagement with the text, potentially leading to greater emotional processing and self-reflection.
Critical appraisal of poetry for therapeutic use aligns with the concept of “bibliotherapy,” which involves the careful selection of literary works for therapeutic purposes. Hynes and Hynes-Berry12 emphasized the importance of choosing appropriate texts that resonate with patients’ experiences and promote healing. Poems addressing resilience, hope, and transformation may be particularly relevant for cancer patients.
Considering a poem’s broader applicability for individual reflection and growth extends the potential benefits beyond the clinical setting. This aligns with the findings of Tegner et al.,1 who observed that cancer patients continued to reflect on and find meaning in poetry outside of structured sessions.
Pehrsson and McMillen13 reviewed bibliotherapy practices and found that the effectiveness of literary interventions often depends on the facilitator’s ability to select appropriate texts and guide reflection. This underscores the importance of the critical appraisal step in the proposed multifaceted approach.
Bozcuk et al.2 demonstrated the positive effects of art therapy on the quality of life of cancer patients. While their study focused on visual arts, their structured approach to integrating art into cancer care provides a model that could be adapted for poetry interventions.
Various researchers have explored the use of specific poems, such as “Still I Rise” by Maya Angelou, in therapeutic settings. Stepakoff14 discussed the use of Angelou’s poetry in group therapy sessions, noting its ability to inspire resilience and self-empowerment. This supports the idea of critically appraising individual poems for their therapeutic potential.
Rickett et al.3 explored the role of poetry writing in psychosocial oncology. Their findings on how patients create meaning through poetry could include how patients interpret and apply existing poetry to their own experiences, as proposed in the multifaceted approach.
Carroll10 argued for integrating poetry into nursing practice, suggesting that nurses could benefit from training in literary analysis to better facilitate poetry interventions. This aligns with the proposed approach’s close reading component.
While this multifaceted approach shows promise, it is essential to note that more research is needed to validate its effectiveness. Future studies could compare outcomes between traditional poetry therapy methods and this more structured approach. Additionally, research could explore how different types of poetry and varying levels of analysis complexity impact therapeutic outcomes for cancer patients at different stages of their illness and treatment.
Multifaceted Approach to Poetry Reading: Enhancing Meaning-Making and Spiritual Growth in Cancer Care
The multifaceted approach to poetry reading, incorporating close reading, critical appraisal, and broader applicability analysis, shows promise in facilitating meaning-making and spiritual growth for cancer patients. This method can be particularly useful in addressing the existential and spiritual challenges often faced by individuals dealing with cancer.
Breitbart et al.15 developed a meaning-centered psychotherapy intervention for advanced cancer patients, emphasizing the importance of finding meaning in the face of serious illness. While their approach did not specifically use poetry, the principles of meaning-making they identified could be effectively addressed through the proposed multifaceted poetry reading method. The close reading component, in particular, can help patients uncover layers of meaning in poems that resonate with their experiences.
Lin et al.16 conducted a study on the effects of meaning-making intervention on the spiritual well-being of patients with advanced cancer. They found that interventions focused on meaning-making significantly improved spiritual well-being and quality of life. The critical appraisal step in the multifaceted approach could be tailored to select poems that specifically address themes of spirituality and existential meaning, potentially enhancing the intervention’s effectiveness.
Puchalski17 has extensively studied the concept of spirituality in cancer care and argues for its integration into comprehensive cancer care. The broader applicability analysis in the multifaceted approach aligns with this perspective, as it encourages patients to reflect on how the poems’ themes relate to their spiritual beliefs and experiences beyond the clinical setting.
Karczewski et al.18 explored expressive writing in cancer patients and found that it contributed to meaning-making and spiritual growth. The multifaceted approach to poetry reading could complement expressive writing interventions, providing patients with rich textual material to inspire their reflections and writings.
McCoubrie and Davies19 investigated the relationship between spirituality, meaning, and quality of life in cancer patients. They found that existential well-being (finding meaning and purpose) was more strongly associated with quality of life than religious well-being. This suggests that the meaning-making aspect of the multifaceted poetry approach could be particularly beneficial, even for patients who do not identify with specific religious traditions.
Ando et al. 20 developed a short-term life review interview program focused on meaning-making and spirituality for cancer patients. They reported improvements in spiritual well-being and alleviation of psychosocial distress. The multifaceted poetry approach could be integrated into such programs, using poems as life review and reflection prompts.
Visser et al.21 conducted a systematic review of spiritual interventions for cancer patients and found that interventions addressing meaning-making were among the most effective in improving spiritual well-being. The structured nature of the multifaceted approach, particularly the critical appraisal step, could help ensure that poetry interventions consistently address meaning-making aspects.
Regarding specific poetry use, Tegnér et al.1 noted that cancer patients often found spiritual comfort and transcendent experiences through poetry reading. The close reading component of the multifaceted approach could help patients identify and explore these spiritual elements more deeply.
Olson-McBride and Page7 observed that poetry therapy sessions often naturally led to discussions of spiritual and existential themes. The broader applicability analysis in the multifaceted approach could capitalize on this tendency, encouraging patients to connect poetic themes to their spiritual journeys and search for meaning.
While these studies suggest the potential of the multifaceted poetry approach in promoting meaning-making and spiritual growth for cancer patients, it is essential to note that more specific research is needed. Future studies should directly evaluate the effectiveness of this structured approach compared to other interventions. Additionally, research could explore how different types of poetry and varying levels of analysis complexity impact spiritual well-being and meaning-making for cancer patients at different stages of their illness and treatment.
Benchmarking the Practice in Evidence Synthesis and Statements of Recommendations
Researchers and clinicians can utilize structured questionnaires for each component to implement this multifaceted approach effectively. After conducting critical appraisal and broader applicability assessments, it is essential to synthesize the evidence to ensure that the selected poetry interventions are of high quality and relevant to the patient population. This synthesis involves evaluating the credibility, reliability, and therapeutic value of the poetry, ensuring that the interventions align with the clinical objectives and spiritual needs of the patients.
By systematically analyzing the quality of the poetry and its relevance to the patients’ experiences, clinicians can formulate evidence-based recommendations that guide the integration of poetry therapy into cancer care. These recommendations serve as a foundation for developing practical interventions that are both meaningful and effective.
Including these recommendations in the supplementary material, through structured questionnaires, allows for consistent application and evaluation across different clinical settings. This practice not only ensures that the interventions are tailored to the specific needs of cancer patients but also facilitates ongoing assessment and refinement of the approach. The inclusion of these questionnaires helps to standardize the implementation process, making it easier to measure outcomes, share best practices, and improve the overall quality of care.
Thus, the integration of evidence synthesis into this multifaceted approach not only enhances the therapeutic potential of poetry interventions but also ensures that they are grounded in rigorous analysis and tailored to foster both emotional and spiritual well-being in cancer patients.
The following supplementary materials provide examples of such tools:
Supplementary Material 1: Close Reading Questionnaire
Initial Reading:
What is the overall theme or central idea conveyed in the poem?
How does the poem’s tone influence your initial impression of its content?
What structural elements stand out upon your first reading of the poem?
Analysis of Language and Diction:
How does the poet’s choice of words contribute to the poem’s overall meaning and tone?
How do the connotations of specific words or phrases add depth to the poem’s message?
What literary devices are employed by the poet to enhance the imagery and convey emotions?
Exploration of Imagery and Sensory Details:
How effectively does the poem create vivid mental images or evoke sensory experiences?
What sensory details are used by the poet to engage the reader’s imagination?
In what ways do the imagery and sensory details contribute to the poem’s thematic exploration?
Identification of Themes and Motifs:
What themes, motifs, or symbols recur throughout the poem?
How do these themes interact to convey the poem’s deeper meaning?
The exploration of these themes reveals what insights into human experience or universal truths.
Evaluation of Structure and Form:
How does the poem’s structure, including line breaks and stanza organization, contribute to its overall impact?
What effect does the rhythm and rhyme scheme (if applicable) have on the poem’s tone and mood?
Are any structural elements that enhance or detract from the poem’s coherence and readability?
Assessment of Sound and Musicality:
How does the poem’s rhythm and cadence contribute to its aesthetic appeal?
When read aloud, what specific phonetic qualities or sound patterns are most noticeable in the poem?
In what ways do the poem’s sonic elements enhance its emotional resonance?
Interpretation and Critical Reflection:
What is your interpretation of the poem based on your analysis of its language, imagery, and themes?
What strengths and weaknesses do you identify in the poem’s execution and effectiveness?
How does the poem provoke emotional responses or stimulate intellectual inquiry?
Contextual Considerations:
How does knowledge of the poet’s background or historical context inform your understanding of the poem?
What cultural or biographical factors may have influenced the creation of the poem?
In what ways does situating the poem within its broader context deepen your appreciation of its significance?
Comparison and Contrast (Optional):
How does the poem compare to other works by the same author or within the same literary tradition?
Are there similarities or differences in themes, styles, or techniques between this poem and others?
Examining the poem about its literary context reveals what insights?
Synthesis and Conclusion:
How do the various elements of the poem interact to create a cohesive and meaningful whole?
What overarching insights or conclusions does your analysis of the poem lead to?
What lasting impression does the poem leave on you, and how has your understanding of it evolved through critical appraisal?
Supplementary Material 2: Critical Appraisal and Broader Applicability Checklist
Authentic Emotional Engagement
Relevance to Accompaniment Goals: Does the poem’s themes, imagery, and emotional resonance align with the accompaniment goals and objectives during the poetry reading and expression session? The objective is to assess engagement, emotional response, self-exploration, connection, and the transfer of insights to daily life. How does the poem’s content relate to the patient’s presenting concerns and accompaniment needs?
Accessibility and Engagement: Is the poem accessible in terms of language, structure, and complexity? Does it foster active participation and emotional connection for the patient?
Emotional Impact: How does the poem impact the patient emotionally? Does it evoke authentic emotional responses like empathy, validation, catharsis, or insight? How does the poem help patients explore and process their emotions in a safe and supportive environment?
Depth of Meaning: How deep is the meaning and symbolic resonance within the poem? What interpretation and metaphorical significance layers enrich the patient’s understanding and personal reflection? How does the poem encourage introspection and insight into the patient’s inner world?
Cultural Sensitivity and Diversity: Does the poem acknowledge and respect the patient’s cultural background, values, and identity? Are the themes and perspectives inclusive and relevant to the patient’s lived experiences?
Facilitative Potential: What is the poem’s potential to facilitate accompaniment processes, such as self-expression, self-reflection, empathy, perspective-taking, and meaning-making? How can the poem be integrated into accompaniment activities, discussions, or creative expressions to support the patient’s growth and healing?
Ethical Considerations: Are there any ethical considerations related to the selection and use of the poem in the poetry reading and expression? How does the poem contribute positively to accompaniment while respecting the patient’s autonomy, privacy, and dignity?
II. Universal Emotional Resonance
Universal Themes: To what extent do the themes and messages of the poem resonate universally, transcending background, culture, or personal experiences? Does the poem address fundamental aspects of the human condition, such as love, loss, resilience, identity, and personal growth?
Cultural Sensitivity and Diversity: How culturally sensitive and inclusive is the poem? Does it acknowledge and respect the diversity of human experiences and perspectives, reflecting a range of voices and identities?
Flexibility and Adaptability: How flexible and adaptable is the poem for use in various accompaniment contexts, including individual poetry reading and expression, group poetry reading and expression, community settings, and diverse treatment modalities? Can the poem be effectively integrated into different diagnostic and therapeutic approaches and activities to support patients with varying needs and preferences?
Accompaniment Potential: What is the poem’s potential to facilitate accompaniment and outcomes, such as self-expression, emotional exploration, insight generation, empathy building, and personal transformation? How can the poem be tailored to address specific accompaniment goals and objectives, supporting patients in their healing journey?
Clinical Experience and Expertise: How does the poem align with evidence-based practices, theoretical frameworks, and ethical guidelines in poetry reading and expression, drawing on clinical experience, expertise, and professional judgment? In what ways does it complement other diagnostic or therapeutic interventions and modalities?
Patient Feedback and Response: What is the patient’s feedback and response regarding their experience with the poem? What emotional reactions, insights, and perceived benefits of accompaniment do they express? How do patients’ feedback and preferences inform the selection and use of poems in the accompaniment process?
Supplementary Material 3: Classification Guide of a Poem’s Quality, Relevance, and Effectiveness
Quality:
Excellent:
Poems in this category exhibit exceptional craftsmanship, linguistic precision, and artistic merit.
They demonstrate profound thematic exploration, innovative use of poetic devices, and a distinctive voice.
The language is rich, evocative, and masterfully executed, enhancing the poem’s depth and resonance.
These poems represent the highest standard of literary achievement and are likely to impact readers profoundly.
Good:
Poems in this class demonstrate proficient craftsmanship and competence.
They showcase clear, expressive language and effective use of poetic devices to convey their themes.
While they may lack the innovative flair of excellent poems, they are well-crafted and engaging.
Fair:
Poems in this category exhibit essential craftsmanship and may need more originality or depth.
The language and use of poetic devices are functional but may need more distinction or creativity.
While they may have some redeeming qualities, such as coherence or clarity, they only stand out somewhat among literary works.
Relevance:
Highly Relevant:
Poems in this class address universal human experiences and offer timely, thought-provoking insights.
They resonate deeply with readers across diverse backgrounds and contexts.
The themes explored are pertinent, meaningful, and have broad applicability.
Moderately Relevant:
Poems in this category address everyday human experiences and offer meaningful insights.
While they may lack some universality, they are relevant to their intended audience or context.
They resonate with readers to varying degrees and offer valuable perspectives.
Somewhat Relevant:
Poems in this class address specific or niche topics that may resonate with a narrower audience.
They offer insights or perspectives that may be meaningful to some readers but need broader applicability.
While they may have some relevance, they may not engage a broad audience or address universally relatable themes.
Effectiveness:
Highly Effective:
Poems in this category elicit strong emotional responses and prompt deep reflection and engagement.
They effectively communicate their themes and messages, leaving a lasting impression on readers.
Using poetic devices and language is impactful, enhancing the poem’s resonance and aesthetic appeal.
Moderately Effective:
Poems in this class elicit moderate emotional responses and prompt some degree of reflection and engagement.
While they may need more of the impact of highly effective poems, they effectively convey their themes and messages to readers.
While the poem utilizes poetic devices and language to achieve effectiveness, the execution may not be as skillful as in highly effective poems.
Somewhat Effective:
Poems in this category may elicit minimal emotional responses and prompt limited reflection or engagement.
While they may somewhat convey their themes and messages, they need more impact and resonance of more effective poems.
The use of poetic devices and language may be lacking or inconsistent, detracting from the poem’s overall effectiveness.
Supplementary Material 4: Classification of Recommendations
Strong Recommendation:
This highest class of recommendation is attributed to poems that exhibit outstanding quality, relevance, and effectiveness in synthesizing evidence.
These poems showcase exceptional craftsmanship, profound thematic exploration, and impactful communication of ideas.
They resonate deeply with readers, evoking strong emotional responses and fostering significant reflection and engagement.
Highly relevant to a broad audience, these poems address universal human experiences and offer timely, thought-provoking insights.
Readers are strongly encouraged to engage with these poems as they can inspire profound personal growth and transformation.
Strong recommendations are reserved for poems that represent the pinnacle of literary achievement and are likely to have a lasting impact on readers.
Moderate Recommendation:
This intermediate class of recommendation is assigned to poems that demonstrate good to average quality, relevance, and effectiveness in synthesizing evidence.
These poems exhibit proficient craftsmanship and competence, although they may need more depth or complexity in thematic exploration.
They resonate with readers to varying degrees, eliciting moderate emotional responses and prompting some reflection and engagement.
Relevant to their intended audience or context, these poems address everyday human experiences and offer meaningful, relatable insights.
While not exceptional, they contribute positively to the poetic landscape and may offer valuable perspectives or messages to readers.
Poems that demonstrate competence and effectiveness but may not stand out significantly among other literary works receive moderate recommendations.
Limited Recommendation:
This lowest class of recommendation is attributed to poems that exhibit below-average quality, relevance, and effectiveness in synthesizing evidence.
These poems demonstrate limited craftsmanship and artistic merit, lacking originality, depth, or resonance.
They may need to resonate with readers or evoke significant emotional responses, leading to minimal reflection or engagement.
These poems have limited relevance to their intended audience or context and may address obscure or trivial topics with little resonance.
While they may have some redeeming qualities, such as basic competence, they are unlikely to leave a lasting impression or convey meaningful insights.
Poems that are low in quality, relevance, or effectiveness and may not offer significant value to readers receive limited recommendations.
It is important to note that the author initiated the proposed structured questionnaires (Supplementary Materials 1-3) to implement the multifaceted approach to poetry reading in cancer patient care. These tools should be viewed as preliminary frameworks rather than validated instruments. The author invites researchers and clinicians to further develop, refine, and validate these questionnaires through rigorous empirical studies and clinical applications.
The goal of sharing these initial tools is to stimulate further research and methodological development in the field of poetry therapy for cancer patients. Researchers are encouraged to adapt these questionnaires to specific patient populations, cultural contexts, and poetry selections. Additionally, validation studies are needed to establish the reliability and validity of these tools in clinical settings.
As the field progresses, it is hoped that these questionnaires will evolve into robust, standardized instruments that can effectively guide poetry interventions for cancer patients. The author welcomes feedback, modifications, and collaborative efforts to enhance these tools and advance the integration of poetry reading into comprehensive cancer care.
References:
Tegnér I, Fox J, Philipp R, Thorne P. Evaluating the use of poetry to improve well-being and emotional resilience in cancer patients. J Poetry Ther. 2009;22(3):121-31.
Bozcuk H, Ozcan K, Erdogan C, Mutlu H, Demir M, Coskun S. A comparative study of art therapy in cancer patients receiving chemotherapy and improved quality of life by watercolor painting. Complement Ther Med. 2017;30:67-72.
Rickett C, Greives C, Braun J. “What we can learn from cancer patients”: Exploring the role of poetry-writing in psychosocial oncology. J Poetry Ther. 2011;24(3):139-55.
Koenig HG. Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry. 2012;2012:278730.
Pennebaker JW. Expressive writing in psychological science. Perspect Psychol Sci. 2018;13(2):226-9.
Furman R, Downey EP, Jackson RL, Bender K. Poetry therapy as a tool for strengths-based practice. Adv Soc Work. 2002;3(2):146-57.
Olson-McBride L, Page TF. Song to self: Promoting a therapeutic dialogue with high-risk youths through poetry and popular music. Soc Work Groups. 2012;35(2):124-37.
Fancourt D, Finn S. What is the evidence on the role of the arts in improving health and well-being? A scoping review. Copenhagen: WHO Regional Office for Europe; 2019. (Health Evidence Network synthesis report 67).
Charon R. Narrative medicine: Honoring the stories of illness. Oxford: Oxford University Press; 2006.
Carroll R. Finding the words to say it: The healing power of poetry. Evid Based Complement Alternat Med. 2005;2(2):161-72.
Furman R. Poetry and narrative as qualitative data: Explorations into existential theory. Indo-Pac J Phenomenol. 2007;7(1):1-9.
Hynes AM, Hynes-Berry M. Biblio/poetry therapy – The interactive process: A handbook. St. Cloud, MN: North Star Press; 1994.
Pehrsson DE, McMillen P. A bibliotherapy evaluation tool: Grounding counselors in the therapeutic use of literature. Arts Psychother. 2005;32(1):47-59.
Stepakoff S. From destruction to creation, from silence to speech: Poetry therapy principles and practices for working with suicide grief. Arts Psychother. 2009;36(2):105-13.
Breitbart W, Rosenfeld B, Gibson C, Pessin H, Poppito S, Nelson C, et al. Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psychooncology. 2010;19(1):21-8.
Lin HR, Bauer-Wu SM. Psycho-spiritual well-being in patients with advanced cancer: an integrative review of the literature. J Adv Nurs. 2003;44(1):69-80.
Puchalski CM. Spirituality in the cancer trajectory. Ann Oncol. 2012;23 Suppl 3:49-55.
Karczewski M, Ruscio AM, Schueller SM. Experiences with and perceptions of expressive writing for breast cancer survivors: Results from a qualitative study. Support Care Cancer. 2021;29(5):2777-85.
McCoubrie RC, Davies AN. Is there a correlation between spirituality and anxiety and depression in patients with advanced cancer? Support Care Cancer. 2006;14(4):379-85.
Ando M, Morita T, Akechi T, Okamoto T. Efficacy of short-term life-review interviews on the spiritual well-being of terminally ill cancer patients. J Pain Symptom Manage. 2010;39(6):993-1002.
Visser A, Garssen B, Vingerhoets A. Spirituality and well-being in cancer patients: a review. Psychooncology. 2010;19(6):565-72.
Susano B. Tanael Jr1
1 Section of Medical Oncology, Jose R. Reyes Memorial Medical Center, Sta Cruz, Manila
Corresponding author: Susano B. Tanael Jr; susano.tanael@gmail.com
ABSTRACT
Background: Poetry has emerged as a promising tool in creation of meaning for healing in patients with life-limiting illness, promoting emotional engagement, self-reflection, and empathy. This study explores the potential of Maya Angelou’s “Still I Rise” as a tool for accompaniment in various contexts.
Methods: A multifaceted approach was employed. First, a close reading of “Still I Rise” analyzed its core message, literary devices, and their impact on the reader. Second, a critical appraisal assessed the poem’s suitability for accompaniment, considering its alignment with the session’s goals and its potential to promote emotional processing and self-reflection. Finally, the analysis considered the poem’s broader applicability for individual reflection and growth beyond a clinical setting.
Results: The close reading revealed that “Still I Rise” conveys a powerful message of resilience and overcoming adversity. The poem utilizes vivid imagery, strong verbs, and repetition to emphasize its central theme. The critical appraisal suggested that the poem’s themes resonate with therapeutic goals, and its emotional impact can facilitate the exploration and validation of challenging experiences. The poem’s cultural sensitivity and versatility make it adaptable in various accompaniments and individual reflections beyond clinical settings.
Discussion: While the focus on a single poem and the inherent subjectivity of interpretation are limitations, this study highlights the potential of “Still I Rise” as a tool for accompaniment. Future research could explore the comparative effectiveness of different poems and investigate reader responses across diverse backgrounds.
Conclusion: “Still I Rise” possesses significant potential as a tool for accompaniment due to its ability to resonate with experiences of overcoming adversity and inspire self-affirmation. This study contributes to the understanding that poetry reading and expression promote healing and growth within personal contexts and accompaniments.
Keywords: Poetry reading and expression, “Still I Rise,” Maya Angelou, Resilience, Emotional Processing, Self-Reflection, Personal Growth
INTRODUCTION
Poetry has an extensive historical background in its utilization for the purpose of investigating and articulating human emotions, experiences, and travels. A recent study indicates an increasing acknowledgment of its potential advantages in therapeutic accompaniments. Research has demonstrated that engaging in poetry reading and expression can enhance emotional involvement, introspection, and empathy.1,2 Therapeutic accompaniment in the context of poetry involves using poetry to facilitate therapeutic processes, assisting people in articulating their feelings, thoughts, and experiences.
Integrating poetry into medical education enhanced student professionalism, empathy, and attitudes toward patient care.2 Similarly, research indicates that poetry has the potential to cultivate self-compassion, which is a fundamental component of mental well-being.3 The incorporation of poetry in therapeutic methodologies that prioritize client empowerment and the creation of personal significance.4 Group poetry reading and expression enhanced hope and uplifted mood among women with breast cancer.5
Although there is limited study specifically focused on the therapeutic use of the poem “Still I Rise,” 6 its themes of resilience and triumph over hardship align with the objectives of therapy. Poetry reading and expression intervention enhances emotional resilience and reduces anxiety in cancer patients, underscoring its significance in managing challenges and fostering mental well-being.7
This study seeks to fill this need by investigating the potential of “Still I Rise” as a tool for enhancing the experience of poetry reading and expression. By engaging in a meticulous analysis, we will delve into the poem’s central theme, the various literary techniques employed, and how they affect the reader. A critical appraisal will then analyze the poem’s appropriateness for diagnostic or therapeutic accompaniments, considering its compatibility with diagnostic or therapeutic objectives and its capacity to facilitate emotional processing and self-examination. Ultimately, we will examine the poem’s broader relevance for personal introspection and development outside of a medical environment.
While this study explicitly examines the poem “Still I Rise,” the analysis is inevitably based on personal opinions and perspectives.8 Examining the poem’s meaning and its possible influence can guide companions or advocates on how to employ it to foster sentiments of empowerment and optimism in their patients. Subsequent studies can examine the relative efficacy of various poems and analyze reader reactions among individuals from distinct backgrounds.9 Nevertheless, this preliminary investigation seeks to enhance comprehension of how “Still I Rise” might potently foster healing, self-exploration, and empowerment.
METHODS
A set of questions was developed for close reading and critical appraisal, as more than a single question is often required to capture the depth and intricacy of a literary text fully. The author’s capacity to generate several inquiries arises from a fusion of experience in literary analysis10 and close reading, especially poetry,11 comprehension of reader response,12 and previous exposure to critical appraisal.13,14 The author utilized their knowledge of literature and strong analytical skills to create classification systems that enable a methodical assessment of poems recommended for poetry reading and expression. These systems consider quality, relevance, and effectiveness factors with questions and classification schemes.15
Closely reading Maya Angelou’s “Still I Rise” required sequential steps. First, an in-depth analysis of the poem was conducted, meticulously scrutinizing each line for its selection of words, use of imagery, and incorporation of sound devices. This was followed by an investigation into the underlying themes, structure, and historical context. The research peaked with a synthesis understanding of the poem’s main message, effectiveness, and enduring influence.
A critical appraisal of “Still I Rise” assessed its capacity for diagnostic or therapeutic accompaniment. The analysis centered on how the poem’s subjects, ease of understanding, and ability to evoke strong emotions could enhance patient involvement, introspection, and connection during poetry reading and expression sessions. In addition, it examined the poem’s universality, cultural sensitivity, and versatility for application in various settings and contexts. This evaluation aimed to determine the poem’s efficacy in promoting healing and personal growth among patients.
Critical appraisal determined the appropriateness of Maya Angelou’s “Still I Rise” for poetry reading and expressive sessions. The analysis sought to assess the poem’s value as a tool for facilitating self-exploration and healing in patients, taking into account its quality in terms of literary worth, relevance to session goals, and effectiveness in terms of emotional impact and engagement.
After thoroughly reviewing the criteria indicated above, the evaluation recommended using “Still I Rise” in poetry reading and expression sessions. This evaluation considered the poem’s merits and drawbacks in promoting session objectives and its possible influence on patients.
Although not utilized directly in this study due to its emphasis on attentive reading, the significance of patient comments during a Zoom conference was recognized. The questionnaires included in the supplementary materials provided comprehensive information. These questionnaires can be utilized in future research to collect patient feedback and conduct a more comprehensive assessment of the efficacy of different poems in poetry readings and expression.
RESULTS
Close Reading
Closed reading entails meticulous examination of each line to comprehend the fundamental meaning, tone, and literary techniques employed in the poem. A preliminary analysis determined that the core subject concerns resilience and triumph over hardship. The use of phrases such as “You may” and “Still I Rise” generated a tone of defiance and confidence. The structural elements that are most notable in this text are repetition, rhetorical inquiries, and images of rising.
Subsequently, the language and diction were evaluated. The selection of words such as “defiance” and “empowerment” influences the overall tone. The implications of “rise” (upward mobility) and “trod me in the dirt” (degradation) contribute to depth. Metaphors, such as “rising like moons” and repetition, as shown in “Still I Rise,” amplify the imagery and underlying idea.
Transitioning to the topic of figurative language, the utilization of imagery and sensory information effectively generates vivid mental images, as exemplified by the line “dust, I’ll rise.” Incorporating sensory nuances such as “shoot me with your words” captivates the reader and establishes a connection to conquering obstacles.
All of these factors collectively contribute to the central idea of the poem. The themes and motifs revolve around exploring perseverance, empowerment, and identity. Resilience and self-worth are interconnected, as a strong sense of self-worth contributes to resilience. Additionally, identification has a role in fostering pride and enhancing resilience. The poem emphasizes the innate ability of humans to triumph over adversity, the significance of having confidence in oneself, and the influence of embracing one’s cultural background.
Ultimately, close reading assessed the organization and arrangement. The brevity of the stanzas and the use of enjambment contribute to the generation of momentum. The absence of a rigid pattern of rhyming enhances the speaker’s distinctiveness, but the use of repetition, as shown in the phrase “Still I Rise,” underscores the core idea. The structure of the text improves its readability by employing techniques such as enjambment to add depth.
An in-depth examination of “Still I Rise” also emphasized the poem’s auditory qualities, scrutiny of its influence on the reader, its position in literary chronicles, and the overall lasting effect it imparts.
The examination focused on the poem’s language, tone, and musicality, building upon the previous research. The brevity of the lines and the use of enjambment generate a sense of propulsion, compelling the reader to continue reading. Phonetic elements like alliteration (“huts of history’s”) and consonance (“sassiness, upset, still”) enhance the auditory sensation. Combining these aspects enhances the emotional effect of the poem, making it both meaningful and enjoyable to recite or listen to.
The exploration delved into the reader’s experience, interpretation, and critical thought, shifting the focus accordingly. The poem exults in triumphing over hardship, effectively communicating a potent message with forceful diction, detailed visual descriptions, and themes that resonate with all people. An apparent vulnerability, although possibly a deliberate artistic decision, is the absence of a structured pattern of rhymes. Nevertheless, the poem’s overall effect is unquestionably optimistic, instilling hope and self-confidence while inciting contemplation on intricate subjects such as identity and persecution.
Careful attention was given to the poem’s contextual factors to gain a comprehensive understanding of its potency. Gaining insight into Maya Angelou’s encounter with racism and the Civil Rights era enhances the poem’s significance.16 The pursuit of equal rights serves as a palpable context for the speaker’s resistance. This background is significant because the poem’s message of resilience strongly connects with disenfranchised people who are confronting comparable difficulties.17
Ultimately, analyzing the poem’s position in literary history involved thoroughly examining its similarities and differences with other works. The poem exhibits thematic and stylistic similarities to the works of Angelou and other African American poets; however, it possesses a more resolute and challenging tone. By analyzing its literary background, one may observe the longstanding practice of honoring resilience in African American literature, a legacy that “Still I Rise” confidently upholds.18
Critical Appraisal
Authentic Emotional Engagement
The poem’s substance demonstrates its relevance to reading and expressing poetry with accompaniment. The themes and message align significantly with the evaluation or focus on engagement, emotional reaction, and self-discovery. The direct language, organized organization, and striking pictures further improve this suitable accompaniment. Individuals with different literacy levels can readily engage with the poetry, promoting connection within the accompanying environment.
The poem’s emotional resonance is unquestionable. It elicits emotions such as empathy, validation, and catharsis, which foster a secure environment for clients to examine and deal with their emotions. The poem exhibits profound significance beyond its superficiality, presenting intricate symbolism and numerous levels of interpretation. “Still I Rise” promotes self-examination and deep contemplation, explicitly focusing on resilience and empowerment, fundamental accompaniment elements.
Crucially, the poem demonstrates a strong awareness and respect for many cultures. This statement asserts the value and importance of every person, guaranteeing that its ideas of conquering challenges strike a chord with customers from various backgrounds. This inclusivity establishes a basis for diverse support initiatives. Poetry reading can evaluate and enhance self-expression, introspection, understanding, and the ability to see things from other viewpoints, all of which contribute to creating meaning in conjunction with something else.
Ethical considerations are crucial. Therapists are obligated to guarantee that clients provide their consent after being fully informed, sensitive to cultural differences, and respectful of the client’s independence and privacy. When employed with careful consideration and moral principles, “Still I Rise” can be a potent instrument that enhances client empowerment, a fundamental advantage in any supportive environment.
Universal Emotional Resonance
The critical appraisal also examined the poem’s continuing relevance and impact outside its original context, building upon the previous consideration of its applicability.
The poem’s primary potency resides in its overarching and all-encompassing ideas. It surpasses the limitations of background and culture by exploring essential human experiences such as resilience, empowerment, identity, and progress. The poem’s topics profoundly impact readers, regardless of their social background, making it a potent instrument for personal introspection and development.
In addition, “Still I Rise” exhibits a keen awareness and respect for many cultures. The poem exalts cultural pride while maintaining the inclusivity of many perspectives and experiences, engendering a feeling of affiliation among readers from diverse origins and cultivating a sense of collective humanity.
Another crucial advantage of poetry is its adaptability. This versatility enables its application in various contexts, including individual, group, and community situations. It is versatile and can be adjusted to different accompaniment methods, making it an excellent resource for caregivers. This adaptability also applies to other areas, not just assistance. The poem’s capacity to enable self-expression, emotional investigation, and understanding formation renders it a potent tool for individuals pursuing personal development.
The accompaniments extend beyond particular sessions, and the poem’s potential for accompaniment is unquestionable. It can facilitate the development of empathy and personal growth in different situations. Accompaniment providers can customize their application to target specific objectives, rendering it an exceptionally adaptable instrument for fostering recovery and wellness.
Proficiency and practical knowledge in medicine are essential for optimizing the poem’s influence. Extensive clinical knowledge and skill are also essential for optimizing the poem’s influence in accompaniments, especially when assessing the extent to which a poem corresponds with proven therapeutic methodologies.19 Support care providers can use their professional or personal judgment to ethically and successfully incorporate poetry into their work. Maya Angelou’s “Still I Rise” is an influential and adaptable work that surpasses cultural and individual limitations.
Suitability and Recommendation
The quality of “Still I Rise” by Maya Angelou is outstanding. The poem exhibits exceptional craftsmanship, linguistic precision, and artistic merit. Angelou’s mastery of language and poetic devices is evident throughout the poem, enhancing its depth and resonance. The use of repetition, imagery, and metaphor contributes to the poem’s powerful impact. At the same time, Angelou’s distinctive voice and thematic exploration of resilience and empowerment set it apart as a work of literary excellence. More importantly, the poem is highly relevant as it addresses universal human experiences and offers timely, thought-provoking insights. Themes of resilience, empowerment, and identity resonate deeply with readers across diverse backgrounds and contexts. “Still I Rise” speaks to the enduring human spirit and the universal desire for self-affirmation and empowerment, making it relevant and meaningful to readers worldwide.
Building on this relevance, “Still I Rise” is highly effective in eliciting strong emotional responses and prompting deep reflection and engagement. The poem’s powerful message of resilience and empowerment leaves a lasting impression on readers, inspiring hope, courage, and determination. Angelou’s poetic devices and language are impactful, enhancing the poem’s resonance and aesthetic appeal. Overall, “Still I Rise” is a highly effective poem that effectively communicates its themes and messages, profoundly impacting readers.
Therefore, “The poem ‘Still I Rise’ should be used in reflective reading and expression.” Its outstanding quality, relevance, and effectiveness make it a strong recommendation.
DISCUSSION
Although the author’s questions and classification scheme provide a systematic method for examining poems, its use in a poetry reading and expression context may have some limitations. The inherent subjectivity in formulating questions and designing schemes can limit the participant’s investigation of a poem’s significance. An established framework may fail to consider the distinct emotional reactions and life experiences a cancer survivor brings to the interpretation. In addition, emphasizing categorization within the scheme may detract from the benefits of accompaniment with poetry, thereby impeding the free dialogue and self-discovery essential in a supportive environment.
Nevertheless, it is crucial to recognize that although the author’s inquiries and categorization framework provide helpful instruments for scrutinizing poems, their constraints still need to be revised to nullify the potency of poetry as an accompaniment. Recognizing these constraints enables a more equitable and sophisticated methodology, acknowledging the intricate aspects of poetry such as “Still I Rise.”
“Still I Rise” transcends being merely a poem focused on surmounting hardship. The poem serves as a monument to the resilient human spirit when confronted with adversity. This text serves as a call to action, encouraging readers to discover their resilience and overcome obstacles.
Furthermore, “Still I Rise” is an excellent resource for supportive care providers, aligning with numerous advantages. The poem’s central theme of resilience, empowerment, and triumph over challenges speaks to desired results such as self-discovery and emotional healing. The poem’s accessibility and involvement further reinforce this thematic connection. The poem’s lucid language, well-organized structure, and vivid imagery facilitate comprehension for clients from diverse backgrounds, establishing a feeling of connection and enhancing involvement during accompaniment sessions.
Furthermore, the poetry elicits various feelings, such as empathy, affirmation, and catharsis, establishing a secure environment for individuals to delve into their own emotions and experiences concerning overcoming obstacles. Moreover, the poem’s profoundness and abundance enhance its depth and capacity for contemplation. The profound symbolism and diverse interpretations foster deep introspection and self-examination about the themes of resilience and empowerment, which are fundamental elements of accompaniments. The poem’s message of triumphing over challenges deeply connects with consumers from many ethnic origins, fostering cultural awareness and inclusiveness and serving as a basis for several supplementary activities, such as self-expression, introspection, fostering empathy, and adopting different perspectives, all of which contribute to favorable results in treatment.
Someone who has overcome cancer may find strength and support by reading and contemplating Maya Angelou’s poem “Still I Rise.” The reason is as follows: The poem’s themes of fortitude and self-empowerment have a profound impact. The poem’s primary theme of triumphing over hardship speaks to the obstacles encountered by individuals battling cancer. The visual representation of emerging from the dust and the resolute attitude can evoke a revitalized feeling of resilience and resolve when confronted with illness.
Moreover, “Still I Rise” delves into various sentiments, encompassing adversity, resistance, and eventually victory. It enables individuals who have overcome cancer to examine their intricate feelings and discover affirmation for their challenges.
In addition to evoking solid emotions, the poem tackles the difficulties cancer survivors may encounter regarding their self-esteem. The poem exalts the innate value and honor of each person, especially consequential for individuals who have survived cancer and may struggle with alterations to their physical appearance or self-perception. “Still I Rise” asserts the inherent worth of individuals irrespective of the obstacles they encounter.
“Still I Rise” cultivates personal resilience and instills a feeling of inclusion in a collective encounter. Cancer survivors frequently experience sensations of seclusion. The poem’s overarching themes connect its readers and a broader collective of individuals who have triumphed against hardship, cultivating a feeling of collective humanity and inclusion.
Ultimately, the poem’s message has the potential to stimulate and accelerate individual development. The poem “Still I Rise” has the potential to stimulate introspection and self-reflection among cancer survivors, urging them to contemplate their encounters with resilience and personal development as crucial components in the recovery process.
Although the close reading, critical appraisal, and assessment of suitability for “Still I Rise” provide vital insights, it is crucial to acknowledge certain limits. Initially, the investigation has a narrow scope. The research centers on a solitary poem, “Still I Rise,” by Maya Angelou. The results may not apply to other poems or genres utilized in therapeutic contexts or for personal introspection.2 Furthermore, close reading and critical assessment encompass evaluating the poem’s significance and influence. Although based on evidence, these interpretations can be subjective and susceptible to the reader’s personal background and experiences.20 Finally, the study predominantly centers on the text itself, placing less importance on the reader’s personal experience and the potential impact of external variables on their interpretation.21
In order to assess the efficacy of “Still I Rise” as a supportive instrument, the subsequent phase involves carrying out pilot research involving a solitary individual who has survived cancer. This trial project would entail transmitting the poetry electronically to the survivors, allowing them to read it autonomously. After reading the poem, the survivor will complete a self-directed questionnaire designed to investigate their ideas, emotions, and emotional reactions to the poem. Through analyzing their written comments, we can obtain valuable data on whether the poem enables self-exploration, emotional processing, and connection with the concepts of resilience and empowerment. This preliminary study with a solitary participant will assist in determining whether a more extensive examination into the efficacy of “Still I Rise” as a supportive instrument for individuals who have survived cancer is justified.
CONCLUSION
This study examined the feasibility of utilizing Maya Angelou’s poem “Still I Rise” for close reading, critical appraisal, and assessment of its suitability for poetry reading and expressive purposes. The close reading unveiled the core theme of the poem, which is the ability to bounce back and conquer challenges, accomplished via the use of impactful language, vivid imagery, and literary techniques. The critical appraisal emphasized the poem’s congruence with the session’s objectives and its capacity to facilitate emotional investigation, introspection, and empowerment within an accompanying environment. Moreover, the study indicated that “Still I Rise” is a potent instrument for personal development, thanks to its universal themes and capacity to promote connection and self-exploration.
Although the poem’s examination provides essential insights, it is crucial to recognize its limitations. Concentrating on a solitary poem and the inherent subjectivity of interpretation underscores the necessity for additional investigation. Subsequent research endeavors may delve into the relative efficacy of various poems, scrutinize reader reactions across heterogeneous demographics, and assess the enduring consequences of employing poetry accompaniments for individual development.
Notwithstanding these constraints, our study indicates that “Still I Rise” exhibits substantial promise as a resource for support in many settings. The poem’s propensity to evoke readers’ memories of triumphing over hardship and its power to motivate strength and self-empowerment makes it a powerful tool for anyone seeking personal development and emotional recovery. Additional investigation into the impact of poetry on enhancing well-being is necessary, and “Still I Rise” is a striking illustration of literature’s ability to resonate with the human soul deeply.
While the existing literature suggests potential benefits in terms of both meaning-making and spiritual well-being, it’s important to note that more rigorous research is needed to fully establish the efficacy of poetry interventions in cancer care and other healthcare settings. Future studies should focus on larger sample sizes, standardized interventions, and long-term follow-up to better understand the role of poetry in supporting healing, spiritual growth, and overall well-being for patients.
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